Half a million Americans die in intensive care each year. At any point in time, one hundred thousand patients who have survived initial ICU treatment remain critically ill and dependent on invasive intensive care therapies on a chronic basis. Most of these patients are older adults and all are in need of evidence-based, skillful, and compassionate palliative care. In fact, it is now accepted that palliative care is an essential component of comprehensive care from the outset for every ICU patient and family, regardless of prognosis. Yet ICU palliative care is still deficient, both because empirical evidence is lacking and because existing evidence is not clinically translated in a fimely and consistent way. The Candidate for this K07 award is an experienced clinical investigator who has helped to define a new field of aging research at the intersection of intensive care, palliative care, and geriatrics. Bringing expertise in critical care medicine, palliative medicine, and clinical research, and experience in large-scale translational initiatives in ICUs, she now proposes to create the nation's first program focusing solely and specifically on optimizing palliative care for older adults in ICUs through research and knowledge translation - the Program to Inform and Improve the Quality of ICU Palliative Care for Older Adults (l-QUIP). The Candidate will establish this program at Mount Sinai School of Medicine, which has a worldwide reputation for excellence in geriatric palliative care and has strongly supported her work for two decades. The main aims of this K07 program are to enhance the institution's capacity to i) Contribute new knowledge about palliative care in the ICU setting; li) Translate knowledge more effectively and reliably in clinical practice; and iii) Serve as a national model and resource in this field. The K07 program will support new investigators and collaborations through expert mentoring, individualized training, research infrastructure, pilot funding, and a seminar series addressing relevant methods. It will also promote clinical translation through a new curriculum to be refined and pilot tested at Mount Sinai, followed by broad dissemination. The Investigative and Translational Components of the new program will be closely integrated and synergistic. For the Candidate, the K07 award will provide the opportunity for career development in key leadership areas and protect time to develop, implement and disseminate the l-QUIP Program as an enduring contribution to aging research. RELEVANCE (See Instructions): As the US population ages and critical care treatments are increasingly offered to older and sicker patients, more and more seniors and their families will need high-quality, evidence-based, ICU palliative care. The Institute of Medicine and National Institutes of Health have identified improvement of this care as a public health priority. With this award, the Candidate will establish the nation's first program focusing solely and specifically on optimizing ICU palliative care for older adults through research and knowledge translation.